Source: Annual Congress 2002 - Drug resistance
Disease area: Respiratory infections

Abstract

40 MDR TB chronic patients were treated for 18 month with capreomycin (kanamycine), cycloserine, ofloxacine, PAS and ethambutol, pyrazinamide and ethionamide, if susceptibility was persisted. The average number of drugs used in treatment regimens was 5. 100% were resistant to isoniazid, rifampin and streptomycin, 95% - to etambutol, 32% - to kanamycin, 34% - to ethionamide and 49% - to pirazinamide. 15 were smear and 29 culture positive, both positive were 30 patients (75%). All others were positive 3-7 month before start of treatment and had x-ray signs of TB activity. At the first 2-3 month most often the different gastrointestinal disturbances occurred: diarrhea (63%), nausea (66%), vomiting (42%), reflux (53%), abdomen pain(45%),appetite decreasing (45%) and swelling(11%). Severe psychiatric disorders have occurred after 4 month: 5 patients had acute psychoses and one had convulsions simultaneously; 7 patients had depression. After 3 month 5 patients had severe potassium deficit and decreasing its level below 2.0 mEq. After 9 month in 45% cases hypothyroid syndrome have developed. One patient had hepatitis connected with Z using. In 6 cases episodically we saw transaminases elevating up to 5 folders without disease developing. Usually we did not stop treatment, except severe side effects cases, when we have interruption for 1-2 weeks. Smear and culture conversion registered at 6-7 month of 93%. Bacteriology changes correlated with TB complaints reducingand X-ray positive changes. One patient died of acute coronary insufficient and widespread atherosclerosis. One another died after surgical operation because of TB progress. One patient operated successfully.

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A. Pasechnikov, J. Mucherjee, S. Shin, M. Rich, O. Kostornoy, S. Mishustin, Y. Karpeichik, S. Faraphonov, O. Kosogorova (Boston, United States Of America; Tomsk, Russia). MDR TB treatment in prison. Eur Respir J 2002; 20: Suppl. 38, 3839

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